Debra Lauren Gruda, LCSWR

Primary specialty

Social WorkerTaxonomy code 104100000X

License

071391 Issued in NY

Practice address

26 Spencer St
Farmingdale, NY 11735-3131

Phone

(516) 729-1530

NPI assigned

Feb 4, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Debra Lauren Forman Other name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Debra Gruda LCSW PC

  • Clinical Social Worker
  • Patchogue, NY
  • NPI 1811343049
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1649458548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 732",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117620732",
            "telephone_number": "516-729-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 SPENCER ST",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117353131",
            "telephone_number": "516-729-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUDA",
        "first_name": "DEBRA",
        "middle_name": "LAUREN",
        "name_prefix": "Mrs.",
        "credential": "LCSWR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-04",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "071391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "FORMAN",
            "middle_name": "LAUREN",
            "prefix": "MRS.",
            "credential": "LMSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Social Worker in Farmingdale, NY
• Providers in Farmingdale, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.